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EP789 Sequential use of risk malignancy index and Ca-125 in evaluating adnexal masses
  1. A Bahadur1,
  2. K Khoiwal2,
  3. L Chawla2,
  4. R Mundhra2,
  5. A Gaurav2,
  6. N Bhattacharya2,
  7. P Jha2,
  8. A Yadav2,
  9. S Kumari2,
  10. S Prateek2 and
  11. J Chaturvedi2
  1. 1Obstetrics and Gynecology
  2. 2All India Institute of Medical Sciences, Rishikesh, India


Introduction/Background Adnexal masses have a wide spectrum with respect to age of presentation, signs & symptoms, imaging findings and histopathology report. Pre-operative identification of malignant potential of adnexal masses is important. Ovarian cancer is a significant cause of mortality in menopausal women, large population-based studies demonstrate that the majority of adnexal masses are benign. Exceptionally an ovarian tumour may be malignant and should be treated as early as possible.

Methodology This is a prospective study, conducted at All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India. The data was collected from Department of Gynaecology over a period of eighteen months from June 2017 to December 2018. All women who were diagnosed to have an adnexal mass irrespective of age, parity and menopausal status were included in the study. USG abdomen with pelvis was ordered in all patients followed by CECT or MRI in selective patients. Tumor markers such as Ca-125 were measured, and Risk of Malignancy Index (RMI) was calculated for each tumor. The clinical and imaging findings were correlated with intra-operative findings and finally with the histopathology (HPE) report.

Results A total of 171 women were included in the study who were diagnosed to have adnexal mass. 137 women (80.1%) had benign tumor (Group B) while 34 women (19.9%) were found to have malignant tumor (Group M). Mean age in group B was 37.27±12.88 and in group M was 46.12±13.46 (P value=0.001). Ca-125 was significantly higher in group M (1350 U/ml) than group B (175 U/ml) [P value=0.008). The RMI score was also found to significantly increased in group M than group B (P value=0.007).

Conclusion With respect to adnexal masses, both Ca-125 as well as RMI scoring are important diagnostic tools. RMI scoring has a better overall diagnostic performance than Ca-125 in predicting malignancy.

Disclosure Nothing to disclose.

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